BCG灌流が有効であった上部尿路上皮内癌

SUCCESSFUL BACILLUS CALMETTE-GUERIN THERAPY FOR BLADDER AND BILATERAL UPPER URINARY TRACT CARCINOMA IN SITU: A CASE REPORT

　75歳，女性。尿細胞診陽性を主訴に来院。膀胱と両側上部尿路の同時性CISと診断しBCGの膀胱内注入と上部尿路灌流を行った。左上部尿路灌流はBCG 80mg／生理食塩水80mιを逆行性に2時間かけ，週1回で10回行った。右側は4回のBCG灌流後下部尿管狭窄が出現，中下部尿管を切除し回腸にて尿管を置換した。術後順行性に2回BCG灌流を追加した。完全寛解が得られ治療終了後18か月経過したが再発は認められていない。

A 75 year-old female with positive urine cytology, had carcinoma in situ of the bladder and bilateral upper urinary tract simultaneously. We performed intravesical BCG instillations (Tokyo strain, 80 mg in 40 ml saline) retained for 2 hours weekly for 10 weeks and retrograde perfusion of the left upper urinary tract with BCG (80 mg in 80 ml saline) for 2 hours once a week for 10 weeks.

Although we treated CIS of the right upper urinary tract with the same technique for the left upper tract, right lower ureteral stricture developed after the 4th perfusion with BCG.